But WHY do we need to flatten the curve? (anxiety warning!)

Nollog

Augeo wrote: »

Are you or him going to tell us?

Creator of boards.ie though I don't know how that means anything aside from people know his username from a decade ago.

GreeBo

Alf Veedersane wrote: »

Take a small funnel. Pour a load of water into it quickly....the flow out the bottom is much smaller than what's going in and so lots of water overflows the top.

If you pour water in more slowly, the water goes out the bottom and water doesn't overflow the top.

But the same quantity of water has been through the funnel. In the first instance, where the water went in quickly and overflowed, that overflow is people in need of intensive care but there was no capacity left. The overflow is people dying.

I think its even more basic than that.
There are some people who are going to get COVID-19 and, even with a ventilator, are going to die.
There are many more who will get it and will survive because they got a ventilator.
Flattening the curve means that the healthservice gets to give a ventilator (along with lots of other medical care and attention) to everyone who needs one, not like Italy where they are having to make tough choices and let some people die due to lack or resources.

RiseAbove4

Wasn’t all of this covered by the HSE worker in their Ask Me Anything thread?

I understand (I think) that DeVore is the founder of Boards and he wants us all to take this seriously. But I’m not really sure what more can be done for the gobshítes still not realising what is happening and why we need to follow the guidelines

I’ve believed for about 2 weeks now that these people and the over 60s who won’t stay in will only wake up when a neighbour or relative dies of it

70% of of my intense stress and anxiety since this began is trying to make the parents stay in more. The over 60s aren’t on social media or Reddit or Boards and their reactions to this are paced as such

DeVore; maybe you could link in that HSE worker for their input on those charts etc in your OP?

I’m not really sure what any more of the responsible ones of us can add to what we’re already doing. But I’m starting to think that less time on the Corona sub forum on Boards will help with my own mental health personally

Not cut it out completely, but I think this sub forum is starting to feel like Ireland’s Sky News in discussion board form

GreeBo

A HSE worker, more than likely knows diddly squat about reading and understanding statistics, why would they?

Alf Veedersane

GreeBo wrote: »

I think its even more basic than that.
There are some people who are going to get COVID-19 and, even with a ventilator, are going to die.
There are many more who will get it and will survive because they got a ventilator.
Flattening the curve means that the healthservice gets to give a ventilator (along with lots of other medical care and attention) to everyone who needs one, not like Italy where they are having to make tough choices and let some people die due to lack or resources.

Same principle isn't it? Manage the demand for equipment so that it doesn't exceed the supply.

sydthebeat

Proof the center of the Internet exists in extremes.....

saabsaab

Deleted User wrote: »

This isn't crap. You can download the numbers yourself and do the same calculations and get the same conclusions if you have a reasonable knowledge of statistics. It corresponds with the best knowledge out there.

It irritates me that someone who has built a career and business on mathematical and statistical modelling and the understanding of same is somehow dumb when it comes to modelling medical emergencies and medical personnel are experts at it when the medical professionals turn to people like DeVore when faced with this.

If we ignore people like DeVore, we should just adapt the "herd immunity" strategy and our wonderful heroic medical personnel can end up like those in Italy, Spain, and very soon, the UK and the US.

Don't get me wrong, the medical professionals are fantastic, I have nothing but praise and admiration for them, but they aren't superhuman as some seem to think, they make mistakes too as we well know in this country.

I think they are currently doing a fantastic job, but the Irish people are doing a fantastic job too. The vast majority (99.99+ %) are adhering to social distancing, at least where I live, which wouldn't be the richest part of Cork city by a long shot.

How is the great city of Cork doing these days?

macrocycle_24

I just want to address the double peak seen in the OP post. Might lessen peoples Anxiety!
A recent research paper from Chinese researchers (Find on arxiv.org 2003.12028.pdf) has modeled the outbreak in different countries. The key difference in this model to many other is an estimate of the hidden population of infected people in each country. If this hidden population is small or comparable to the actual number of detected cases, then it is likely that after the peak that once the number of detected infections has fallen to zero then the hidden population will also have fallen to zero. If however the hidden population is large (a scenario that could occur in the UK with low testing) there is a risk of a second outbreak. So a second outbreak is NOT inevitable if detected cases fall to zero and shouldn't happen here in Ireland (outside of risk of importing case from UK or elsewhere again). Also the number of people that will be affected is not fixed it is directly dependent on the mitigation measures taken by the Goverment.

deathbomber

DeVore wrote: »

I think that people are pushing back because they misunderstand the "unmitigated" scenario and think "ah, it wont be that bad".

If you are well informed, then yes... this is not exactly breaking news but there are people here already who are surprised and many others I've seen talking like either they are pyschopathic or (more charitably) not as well informed as you.

Even on this thread we have people saying "yaaawn, knew all this" and other saying "OMG stop scare-mongering"

Rubbish, your causing drama and your stats are based on a now outdated report, a report that also is a model, it is incorrect. Medical professionals are the people to be trusted. During the 1st announcement on partial restrictions, it was noted that we needed to slow the virus down in order to somewhat prevent the health care system being overloaded.
Your stats offer nothing new on this other than a OH MY GOD scenario. It's irresponsible and your answers are somewhat arrogant. You are just another person fighting this pandemic like the rest of us, your stats mean nothing!

ForestFire

Very good thread with good information.

When I saw the first graph, that is widely shown in the media, I was going to post, the dotted line is in the wrong place!

But glad to see that is fully addressed in the rest of the post. Pretending otherwise is just sticking your head in the sand.

If you suffer from anxiety, you should stay off threads clearly discussing the curve and therefore deaths. (do you watch the news on Itay and Spain and think that's some far off fantasy land that cannot happen here?)

I'm sorry but the rest of us are quite entitled to read and contribute to a discussion on how bad things could and are likely get, and the importance of delay and the much needed expansion of ventilators and other ICU equipment. Hopefully it won't come to this but discussions about it should not be suppressed.

The government are announcing more and more measures every week, as the situation develops, but also to ease us in on what might potentially come.

Even the 2 week closure announcement on Friday (most likely to be extended I would say) came as a bit of a surprise to me, but I said when the schools went off, it would be until at least after Easter, but now I would think a return this term is very unlikely.

More announcements tonight coming on health care workers.

Wibbs

Amirani wrote: »

Much more than 1/3 to 1/6 of Covid ICU patients need ventilation. Are you talking about in normal ICU operations?

We've much more ventilators than ICU beds. Every ICU bed will have a ventilator.

I think the ventilation definition may be an issue here? IIRC and sorry it's been a few years since this was explained to me; ventilation for some means O2 by mask, or the oul tubes up the nose, then you'd have intubation with paralytics and sedation attached to a ventilator, then you'd have ECMO which is another level way up again in complexity and monitoring. How many people hospitalised with this virus end up on what protocol? I'm sure that would make a big difference in stresses to the system. EG you have five ventilators and one ECMO setup. In case A you have ten patients and six are on O2 masks, one is on ECMO and three are on intubated ventilation, you've two spare ventilators? However if six needed sedated ventilation you're in trouble. Something like that?

The other problem is that those on ventilation are going to be on it for two or three weeks(unless they pass away in the interim) so that's taking that machine out of the loop for that length of time.

McCrack

DeVore wrote: »

Yeah sorry, I intend to do a post most days to try to bring some science to this discussion. Tomorrows ISNT a second part of todays but it IS more hopeful. I didnt intend to sound like it was a cliff hanger but I also have a company to run, staff to manage from home, a family packed with underlying conditions to tie to chairs and budgets to rip up and redo.

So you keep reminding us however you have statistics experience, you are not medically qualified and you are
extrapolating into something you have no experience or qualifications in and as if you are some authority

Nollog

McCrack wrote: »

So you keep reminding us however you have statistics experience, you are not medically qualified and you are
extrapolating into something you have no experience or qualifications in and as if you are some authority

This is a message board, anyone can make a thread. I could make one right now about something I know nothing about, or something I have a degree in. It's madness, shut it all down.

GreeBo

/\/ollog wrote: »

This is a message board, anyone can make a thread. I could make one right now about something I know nothing about, or something I have a degree in. It's madness, shut it all down.

Ah but DeVore went one further, he created the whole board

deathbomber

Very true, however i see the guy is now the owner of boards which commands a role of influence, no doubt his post is causing anxiety in others, it's quite a silly thing to do!

Alf Veedersane

McCrack wrote: »

So you keep reminding us however you have statistics experience, you are not medically qualified and you are
extrapolating into something you have no experience or qualifications in and as if you are some authority

What he has posted is a study that was carried out and what the varying scenarios are and what they mean. You don't have to have studied medicine to do that.

The intent of the OP is that the curve we are shown doesn't really indicate how important it is to adhere to guidelines because the do nothing scenario would lead us into a situation not far removed from Italy and how all of the measures dampen that. That's the salient point.

I don't really see any points from the OP that they are trying to present themselves as having a background in medicine...Some that are trying to interpret statistics related to medicine.

GreeBo

Another very interesting point (that I have seen on other threads) about ICU beds and COVID-19 is the fact that if all the beds are full of COVID-19 patients, a "normal" incident like a heart attack or stroke or bad fall will now be much more serious as they will have nowhere appropriate to put you.

deathbomber

GreeBo wrote: »

Another very interesting point (that I have seen on other threads) about ICU beds and COVID-19 is the fact that if all the beds are full of COVID-19 patients, a "normal" incident like a heart attack or stroke or bad fall will now be much more serious as they will have nowhere appropriate to put you.

Not necessarily, there will be dedicated wards for other "matters", fact
Obviously less resources to go around though

Melanchthon

This doesn't seem to add much information a problem with this crisis seems to be data scientists throwing around models based on theoreticals and including dubious data like that coming out of China, not a dig a deVore he is in good company with Imperial and Oxford.
Also anybody else suddenly realize how many people they know are involved in data science these days but that's a problem as these models are being thrown around but due to the backgrounds of those involved they don't compare different ICU/ventilation/critical care criteria between countries as thats not the modellers fields.

What I would be curious about and would like somebody with a data science modelling background to look at closer is Korea, Germany, Iceland, Israel and scale the impacts for them as they have the most accurate figures for presence in population.

deathbomber

Melanchthon wrote: »

This doesn't seem to add much information a problem with this crisis seems to be data scientists throwing around models based on theoreticals and including dubious data like that coming out of China, not a dig a deVore he is in good company with Imperial and Oxford.
Also anybody else suddenly realize how many people they know are involved in data science these days but that's a problem as these models are being thrown around but due to the backgrounds of those involved they don't compare different ICU/ventilation/critical care criteria between countries as thats not the modellers fields.

What I would be curious about and would like somebody with a data science modelling background to look at closer is Korea, Germany, Iceland, Israel and scale the impacts for them as they have the most accurate figures for presence in population.

They are testing more, aren't they

Alf Veedersane

deathbomber wrote: »

They are testing more, aren't they

They were, anyway. Data from about 10 days ago had Iceland miles ahead in # tests per million people. I think Ireland are closing in on Germany's rate though.

Melanchthon

deathbomber wrote: »

They are testing more, aren't they

Yes so I would be interested in a model built on the countries with the most accurate idea of how many people are actually infected and how that scales to critical care requirements keeping in mind despite testing being needed it does nothing at all to cure the disease (which is why the fact every article about Germany that goes "the key is to test, test, test" explains nothing about their death rate unless the virus has a thankfully low mortality rate.

Melanchthon

Alf Veedersane wrote: »

They were, anyway. Data from about 10 days ago had Iceland miles ahead in # tests per million people. I think Ireland are closing in on Germany's rate though.

I trust the Icelandic figures quiet a lot as it's from a private company who are likely to have a vested interest in making covid19 appear worse and wouldn't have any pressures to reduce numbers from a government concerned about bond yields etc.
Provision being made they are fairly early on so mortality might be lagging

UrbanFret

Test everybody in Ireland in .an ideal world both north and south. Easy to deal with it then. We need 7 million test kits asap.

shesty

GreeBo wrote: »

Another very interesting point (that I have seen on other threads) about ICU beds and COVID-19 is the fact that if all the beds are full of COVID-19 patients, a "normal" incident like a heart attack or stroke or bad fall will now be much more serious as they will have nowhere appropriate to put you.

Which may feed into a further solution though (again,time).Citywest Hotel is now apparently a step down care facility.There may be plans to create such facilities to keep hospitals clear for ordinary patients - ease of isolation etc.

Another side to all these statistics, and something that the Government are more than aware of (based on their language), is that you cannot quarantine a whole population forever.Italy and Spain are already showing the strain, with public unrest.It might have worked for China, and I know lots of people are advocating a Chinese style lockdown...but we are not China.We never will be.Western democracies are not places where people are used to having to account for their movements.We are accustomed to freedom and a certain standard of living.Imposing massive restrictions on our freedom, and shutting the country for months on end cannot happen, because we can't afford it and people won't take it.

I am only making these points to try and make people understand that this is a solution that will have many "prongs", so to speak.Isolating, distancing are just parts of it. Buying time is just one element of it, but there will probably be a timeline on that 'time buying" exercise.We aren't going to sit and wait for a vaccine, that's the long term solution.But if we can manage both this thing, and our system and resources in the meantime, to keep the flow steady, rather than eliminate it, that is key.

deathbomber

Projected death rates are predicted to come in around 0.9% ish, again from stats/model predictions, won't be known for a few years and also countries like China,Iran etc are under reporting so that is an obvious issue

BarryD2

Sweet.Science wrote: »

All very depressing . We are just slowing down Armageddon

To hopefully allow for treatments to be developed, if not a vaccine.

Melanchthon wrote: »

This doesn't seem to add much information a problem with this crisis seems to be data scientists throwing around models based on theoreticals and including dubious data like that coming out of China, not a dig a deVore he is in good company with Imperial and Oxford.

Garbage in, garbage out.. etc is the old adage. I suppose you have to throw some figures in, but..

deathbomber

BarryD2 wrote: »

To hopefully allow for treatments to be developed, if not a vaccine.

Obviously and they are coming sooner than you think

The antibody test will change a lot, huge difference

shesty

UrbanFret wrote: »

Test everybody in Ireland in .an ideal world both north and south. Easy to deal with it then. We need 7 million test kits asap.

But why? You would want to test everybody every 7 days or so - and with each iteration, test only those who tested negative the previous week (I think?) - in order for that to be useful.

It could take months, which is irrelevant really, but it would show you no particularly useful information until several weeks had passed. Even at that it would probably only tell you what you already know - the thing spreads. Isolation works. But you can't isolate people forever.

With resources and capacity that are there anyway, it would be a pointless exercise and would cause more problems that it would solve.

DeVore

Amirani wrote: »

Much more than 1/3 to 1/6 of Covid ICU patients need ventilation. Are you talking about in normal ICU operations?

We've much more ventilators than ICU beds. Every ICU bed will have a ventilator.

Sorry yes, this is correct. I'll adjust the OP.

We have something of the order of 9 per 100k ICU beds.

RTE (https://www.rte.ie/news/coronavirus/2020/0320/1124290-covid-19-coronavirus-health/) reports 1229 Vents with 900 on order (should be here) and 100 a week.